Common Contracts
1 similar Conditional Agreement contracts
How To Mail Your Contract Licensing ProcedureConditional Agreement • August 16th, 2012 • Florida
BACKGROUND INFORMATION Yes No A. Have you been convicted of, or pled guilty or nolo contendere (“no contest”) to a felony or misdemeanor involving: insurance, investments or a related business, fraud, false statements or omissions, wrongful taking of property, or bribery, forgery, counterfeiting or extortion, or breach of trust? If “yes”, provide explanation below and attach supporting court documentation. B. Have you ever been convicted of, or pled guilty or nolo contendere (“no contest”) to any other felony or misdemeanor? If “yes”, provide explanation below (including date, county, and state in which the felony or misdemeanor occurred) and attach supporting court documentation. C. Has any State Insurance Department or other State or Federal Regulatory Agency ever denied, suspended or revoked your license or registration? If “yes”, provide explanation below and attach supporting documentation. D. Have you personally or a firm that you exercised management control over,
